When was the last time you reviewed the details of the contracts your department is responsible for? Are you intimately familiar with the fine print and the subtle statements that may have significant financial implications?
In many of my conversations with senior executives and HIM professionals, we’ve uncovered gaps in their existing vendor contracts of 10 to 40 percent between what they were presented during the pre-contract phase and what they were actually billed on their invoices.
Begin your investigation on one of the most basic contract terms: the unit of measurement for transcription. Start by ensuring that your contract and billing is based on a standard industry measurement (see definitions below). Your unit of measurement should fit within the industry standard – 65-character lines or visible black character (VBC) measurements, but look very closely for subtle variations. Are you paying for the shift, bold, underscore and other formatting keystrokes? Even within the 65-character and VBC definitions, some companies charge for this formatting and the cost of those extra keystrokes can add up.
So you’ve dug into the contract and reviewed the terms. You’re satisfied that the unit measurement meets industry standards … you know what you’re paying for. The next step is to ensure that the terms of your contract are extended to your invoices. Pull out your bills: do they contain a level of detail that allows you to reconcile against your contract, or do they place doubt?
Contact your vendor if you have questions. Ask for detail and backup. Have that detail included in every invoice going forward. To drill down even deeper, ask for pricing on a sample of completed reports. If your vendor is reluctant to provide the detail and sample reports you’re requesting, you should consider why.
Vendor relations are built on trust. Trust is based on transparency. Is your vendor providing transparency?
* Transcription unit measurements
65-Character Line: Under the 65-character line standard, characters include all letters, numbers, symbols, and formatting codes to maintain and reproduce a document, counting the space bar, shift key, bold, underscore, and other keystrokes. A 65-character line is calculated by counting all defined characters and keystrokes and simply dividing the total number of characters by 65 to arrive at the number of defined lines. Characters appearing in the headers and footers may also be counted.
Visible Black Character: A visible black character is defined as any printed letter, number, symbol, and/or punctuation mark excluding any/all formatting (e.g., bold, underline, italics, table structure, or formatting codes). All visible black characters can be seen with the naked eye as a mark regardless of whether viewed electronically or on a printed page.
Other units of measurements include gross line, gross report, and per-minute pricing. Limitations to these methods have made them unpopular and undesirable.* American Health Information Management Association and Medical Transcription Industry Association, A Standard Unit of Measure for Transcribed Reports, http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_034023.html (February 2007)
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